Facial rejuvenation
with fillers
Tissue volume augmentation with hyaluronic acid in places with the lack of tissue.
10 – 30
min

Duration of the procedure
not
required

Hospitalisation
not
required

Anaesthesia
immediately

Back to work
immediately

Back to sporting activities
Post-operative recommendations
Icing.
Possible inconveniences after the procedure
Swelling, bruise.
Suitable for
Facial rejuvenation with fillers is suitable for:
- correction of nasolabial wrinkles (wrinkles going from the corners of the mouth towards nose),
- correction of the chin,
- correction of cheekbones,
- correction of the nose,
- correction of dark circles under eyes,
- forehead and eyebrow-lift.
About hyaluronic acid
Hyaluronic acid is used in cosmetic surgery for the augmentation of the tissue volume. They are also used for smoothing and reducing wrinkles as well as filling the areas of the skin and subcutaneous tissue with the lack of tissue.
Hyaulornic acid is a transparent viscose gel supplied in a sterile injection. It is a polysaccharid naturally occurring as an important constituent of the skin, subcutaneous tissue, and joints. For aesthetic purposes, non-animal derived formula is used which is why it is safe and it reduces the chance for severe allergic reactions. Hyaluronic acid dissolves with time and does not have a permanent effect. The durability of the effect depends on the formula itself and the body’s reaction to it. Because the body eventually decomposes hyaluronic acid, it needs to be constantly added to have a permanent effect. Hyaluronic acid formulas are often combined with other formulas (e.g. botulin) or with surgical procedures. For a less painful application, a cream with an anaesthetic in it is used or local anaesthetic injections. Hyaluronic acid formulas cause a temporary redness, swelling and tingling sensation which usually go away in a few days.
For a more permanent effect the hyaluronic acid needs to be added.
Most patients do not develop side effects.
Possible inconveniences
With each procedure comes a certain level of risk. Therefore it is important that you understand and accept possible risks and complications related to it. Despite that most patients do not develop side effects.
As a consequence of the hyaluronic acid injection or local anaesthesia, bleeding is possible which is usually limited and manifests as a limited bruise. In very rare cases the bleeding requires additional procedures, even surgical. For a minimum chance of complications it is important that the patient warns the doctor about any possible blood coagulation disorders and to stop taking all medications that could affect the process of blood coagulation, like aspirin, vitamin E, all gynco and other formulas 14 days before the procedure. If the patient is taking cumarins (Marivarin, Sintrom or others), replacement therapy should be introduced according to the doctor’s instructions.
After the procedure
The swelling usually occurs after the application of hyaluronic acid. After the application, visible piercing spots are also normal. Both occurrences disappear in a few days. After the use of hyaluronic acid, the skin can become red on application sites which also goes away within days. At the application sites, the surface of the skin can remain uneven, changes in the form of clods can be felt. This too disappears in time; however, an uneven surface can persist for a longer period of time, even for months. The filler can be visible through a thin skin for a certain period of time.

Additional instructions
Our body and its appearance are anatomically asymmetrical. Occasionally, the exact symmetry thus cannot be achieved with fillers; however, asymmetry can occur due to a different reaction of the body on one side. Correction of asymmetry can require additiona injections of hyaluronic acid.
After the application, the skin is more sensitive to external factors on this sites (heat, cold, UV light). Therefore, it needs to be protected from them for a few more days after the application.
During the application of hyaluronic acid or local anaesthetic, temporary or permanent damage of deeper structures – veins and nerves – can occur. Tissue infections after the application of hyaluronic acid are very rare (less than 1 in 1.000 cases). Nevertheless, bacterial as well as viral and fungal infections can occur. Herpes can also occur (even in patients who never had it before). In persons with common herpetic infections, preventive antiviral medications can be prescribed. Any kind of infection can require additional treatment with antimicrobial medications and surgical procedures as well. This complication can cause permanently visible scar on the skin and in the subcutaneous tissue.
Necrosis is extremely rare complication which can cause visible scars and the need for additional surgical treatment.
Like any biological substance, hyaluronic acid can also cause allergic reaction, in the most severe cases even shock and death. Such reaction can also be a consequence of an allergy to the local anaesthetic.
After the application of hyaluronic acid, painful tightening of the subcutaneous tissue can occur rarely which can require additional treatment and surgical procedures.
Final results
In some cases, patients are not happy with the final result or its durability. It is possible that the body reacts to the filler in an unpredicted way which makes the formula to decompose too quickly. In such cases, we advise to use different fillers or different procedures to achieve the desired result.
Permanent complications due to hyaluronic acid (except the above mentioned) are not known.
Asymmetry correction is done with additional anjections of hyaluronic acid.
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